Extraction of a Torn Epidural Catheter in the Thoracolumbar Junction via Unilateral Biportal Endoscopy.

Abstract

Epidural anesthesia plays a key role in standard delivery procedures nowadays with a low periprocedural complications profile. Tearing of epidural catheters occurs rarely and may require a surgical extraction of the residual fragment. A 26-year-old obese female was referred after spontaneous delivery for an accidentally torn epidural catheter. Imaging revealed a 7 cm residual in the levels Th12-L2 suspected to be located epidurally. The unilateral biportal endoscopic (UBE) technique seemed ideal for exploring different compartments sequentially and for the removal of the material. After an uneventful extraction via the UBE approach, the patient was discharged home on the First postoperative day. We opted for a UBE removal in this case, as the torn catheter ending was located mediolaterally at the thoracolumbar junction and it was not completely evident to us, whether it would be located outside the ligamentum flavum or epidurally. Removal of a torn epidural catheter with the UBE technique is feasible and appears to be a safe and effective minimally invasive option to deal with these postnatal complications.